Articles Posted in Workers’ Compensation

In Broadspire v. Jones, a paper mill employee suffered orthopedic and psychological injuries after he was hurt in a 1981 workplace explosion. After receiving medical care for many years, the man eventually asked to collect attendant care payments for his recently retired wife. The man’s employer denied his request, based on its assertion that the man’s continuing need for treatment was not work-related. Additionally, the employer claimed the services provided by the man’s wife were gratuitous and not compensable.

Following a hearing on the matter, a Judge of Compensation Claims (“JCC”) awarded the injured man 12 hours of attendant care paid to his wife each day under Section 440.13(2)(b) of the Florida Statutes. In response, the employer filed an appeal with Florida’s First District Court of Appeal. In its appeal, the employer argued the JCC’s order was based on the wrong causation standard and was not supported by the record.

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In Babahmetovic v. Scan Design Florida Inc., a Florida man apparently hurt his back when he lifted a heavy box at work in October 2013. Following his injury, the man’s employer authorized an urgent care facility to provide him with treatment. The facility determined the employee’s back harm was work-related and referred him to another physician for follow-up care.

In November 2013, the worker’s treating physician determined the employee suffered from both a workplace injury and a pre-existing degenerative disk condition. Although he indicated the worker’s harm was work-related on a treatment form, the physician sent a letter to the man’s employer stating only 40 percent of his back pain was caused by lifting the heavy box at work. About two weeks later, the man’s employer denied all benefits and stated the workplace incident was not a major contributing cause (“MCC”) of the worker’s need for medical care. According to the employer, the company was permitted to deny all compensability even though it previously authorized medical treatment within 120 days under Section 440.20(4) of the Florida Statutes.

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In Limith v. Lenox on the Lake, an employee was injured in a Florida workplace accident.  As a result, she filed a petition for benefits in 2011.  A Judge of Compensation Claims (“JCC”) later dismissed the petition but reserved jurisdiction over the employee’s claim for legal fees and costs.  In 2013, the JCC denied the employer’s request to dismiss the worker’s claim for lack of prosecution.  Next, the employee sought a follow-up medical visit related to her workplace injury.  Although the JCC denied the worker’s request, he also rejected the employer’s affirmative defense that the statute of limitations enumerated in Section 440.19 of the Florida Statutes had expired.  After that, both parties filed an appeal with Florida’s First District Court of Appeal.

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In Cuenca v. Nova Southeastern University, a Florida dental assistant was injured when she suffered a serious allergic reaction at work in 2013. According to the worker’s petition for benefits (“PFB”), the woman’s injury resulted after she came into contact with an adhesive spray during the course of her employment. As a result, the employee sought reimbursement for her resulting medical care and certain prescription medications.

After the worker filed her PFB, her employer changed servicing insurers. The employer also notified the woman that the previous insurance servicer had no further responsibility for her claim and the new insurer would handle her PFB going forward. In an order filed about two months after the dental assistant sought workers’ compensation benefits, a Judge of Compensation Claims (“JCC”) approved the employer’s change in servicing insurers.

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In Perez v. Southeastern Freight Lines, Inc., a Florida man was injured in a workplace accident. After the incident occurred, the man’s employer stipulated that his injury was compensable under state workers’ compensation laws. Despite this, a Judge of Compensation Claims (“JCC”) denied the injured worker’s request for temporary total disability benefits because he failed to produce objective medical evidence related to his injury. At a hearing, the JCC adopted the test enumerated in Section 440.09(1) of the Florida Statutes which stated the worker’s disability determination must be based on such evidence.

Next, the employee appealed the JCC’s decision to Florida’s First District Court of Appeals. On appeal, the hurt man stated the JCC applied the wrong legal test when considering his worker’s compensation claim. The employee argued that Section 440.09 of the Florida Statutes instead applied to his case because it governed compensability in the workers’ compensation context. Since the worker’s employer stipulated to compensability, the employee claimed the JCC’s order should be overturned.

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In Mitchell v. Osceola County School Board, a Florida woman was working at a veterinary clinic that was being hosted by a non-profit organization and held at an Osceola County high school. While assisting at the clinic, the woman allegedly suffered an injury when she was bitten by a dog. After the incident, the woman filed multiple workers’ compensation benefits claims against both the non-profit organization that employed her and the school board. Eventually, the woman dismissed her claims against the non-profit organization because the group did not carry workers’ compensation insurance coverage.

At a hearing before a Judge of Compensation Claims (“JCC”) the woman argued there was an employer-employee relationship between herself and the school board. In support of her claim, the woman stated the board was her statutory employer under the plain language of Section 440.10(1)(b) of the Florida Statutes. After the JCC rejected the woman’s assertion that she was a school board employee under the law, she filed an appeal with Florida’s First District.

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In American Airlines v. Hennessey, an employee injured his right leg in a workplace accident. As a result, he was required to undergo several hospitalizations and a lengthy course of antibiotics. Due to the extent of the man’s injuries, his employer authorized him to receive attendant care in his home until he was healed.

About two months after the on-the-job accident, the man sought authorization for attendant care beginning on the date of his harm. In support of his request, the man submitted an undated handwritten note from his doctor stating that the hurt man’s wife took non-professional care of him 24 hours per day since he was injured. Later, the physician clarified that the man’s injuries merited attendant care for at least 12 hours per day for a period of about four months beginning on the date of the workplace accident. This included “bathing, cooking, cleaning, and dressing type functions as well as transportation.”

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In Shannon v. Cheney Bros., Inc., a man suffered a workplace back injury in October 2010. The man’s employer accepted liability for the injury and authorized the employee to seek medical treatment. Later, the employee was involved in a traffic collision that was not related to work. As a result of the accident, the worker suffered additional back harm. Not long after the crash occurred, the man’s doctor stated it was his medical opinion that the employee’s workplace injury was no longer the major cause of his need for medical care. As a result, the man’s employer denied his request for follow-up medical treatment.

Next, the injured worker filed two requests for medical benefits related to his back harm. While his requests were pending, the worker sought an advance workers’ compensation payment. Following an evidentiary hearing before a Judge of Compensation Claims (“JCC”), the man’s request was denied and the worker did not appeal the decision. Several months later, the JCC also denied the employee’s two petitions for medical benefits. The worker then appealed each of the JCC’s decisions to Florida’s First District Court of Appeal.

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In City of Fort Pierce v. Spence, an employee was hurt in a 2012 work-related car accident. Following the collision, the man’s employer admitted that his claim was compensable. An authorized physician recommended that the worker undergo a number of procedures on his back, including facet injections and orthopedic surgery. In a deposition, however, the doctor stated a degenerative spinal condition that was diagnosed prior to the accident was about 70 percent responsible for the worker’s need for the facet injections. The doctor also said the condition was normal for a man who was the worker’s age. Following a hearing before a Judge of Compensation Claims (“JCC”), the man received a discounted award related to the facet injections. In addition, the JCC denied the man’s orthopedic surgery claim.

On appeal, Florida’s First District stated the medical evidence offered in the case suggested that the man’s pre-existing degenerative condition was the major cause of his need for the facet injections. The court held that the JCC misapplied the law when she took into account the physician’s statement that the man’s back disorder was normal given his age. According to the appellate court, the relevant inquiry was whether the underlying condition independently required treatment before the employee was hurt at work. Since the medical evidence suggested it did, the District Court of Appeal of Florida, First District overturned the JCC’s award for the facet injections and affirmed her decision on all other counts.

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In Jackson v. Columbia Pictures, a Florida man suffered a traumatic brain injury in 1986 when he fell more than 20 feet at work. Two years later, the brain-damaged worker reached “maximum medical improvement.” Eventually, the hurt man received a workers’ compensation award that included any attendant care benefits that were medically necessary. During the intervening years, the brain-damaged man was incarcerated on two separate occasions.

In 2008, a Judge of Compensation Claims (“JCC”) determined that the injured man required care around the clock during his incarceration. As a result, the JCC entered an order for the amount of services “actually rendered” to the worker. Two years later, the injured man filed a petition seeking payment for the costs associated with the 24-hour attendant care he received while he was in prison.

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